Organization
TOTAL IMAGING-NORTH ST PETERSBURG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAVELLE HARDIN (CREDENTIALING COORDINATOR)
(615) 344-8203
Entity
Organization
Contact information
Practice address
6006 49TH ST N, STE 140, ST PETERSBURG, FL 33709-2148
(727) 528-5900
(727) 528-5911
Mailing address
6006 49TH ST N, STE 140, ST PETERSBURG, FL 33709-2148
(727) 528-5900
(727) 528-5911
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
261QR0206X
Mammography Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
V3085
BCBS OF FL
FL
Enumeration date
10/26/2006
Last updated
09/11/2008
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